Provider Demographics
NPI:1891085353
Name:COON, RYAN ALLYN (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ALLYN
Last Name:COON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-5000
Mailing Address - Fax:
Practice Address - Street 1:280 SMITH AVE N
Practice Address - Street 2:DOCTOR'S PROFESSIONAL BUILDING SUITE 450
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2424
Practice Address - Country:US
Practice Address - Phone:651-241-5959
Practice Address - Fax:651-241-5958
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN558792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH400234077Medicare PIN